ASQ-3 Goto: www.linkdoc.bravesites.com . Click on ASQ-3 in menu bar and then enter password: phcsphn. Then click on age you are looking for and see scoring sheet on last page.
Pediatric Algorithms
Speech Delay Referrals if under 3 y/o (36 months):
Check hearing (ccLink referral to Audio)
Check Development i.e. ASQ-3, ASQ-SE, M-CHAT if concern of Autism Spectrum Disorder (ASD)
Refer to RCEB 510-618-6195 to assess and serve. (Complete and fax Early Start Interagency Form to 510-618-7763 available on iSite/Wiki. Parent should sign consent on form prior to faxing.) Clinic notes, Audio results and if M-CHAT results available, should be included with referral. Advise family follow up with a phone call to RCEB to "START" the timeline. If the family doesn't respond to RCEB within three tries, the case will be closed/not pursued.
Speech Delay Referrals if over 3 y/o:
Check hearing (ccLink referral to Audio)
Check Development
Is there a question of ASD?
Refer to RCEB intake phone 510-618-6122. (Family should call to start timeline. To expedite process, provider should send clinic info re: concern to RCEB.) You can fax Pediatrician RCEB Referral form located on CCRMC WIKI site.
Public school - Preschool assessment -Parent calls local school district to begin the preschool assessment process. School Districts(Phone & fax numbers may have changed please see website for current information) Click here for directory
If the child is already known to have a hearing loss or is deaf hard of hearing (DHH), please consider the local school district for the Solely Low Incidence program, regardless of the age. In addition, for vision, hearing, or orthopedic impairments in children birth to three, please contact the local school district and/or CCC Office of Education www.cccoe.k12.ca.us
Gross Motor Delay Referrals
If under 3 y/o:
RCEB
Pediatric or CHO Neuro eval, if indicated
CCS, if specific criteria are met
If over 3 y/o:
Peds Referral
CHO Pedi-Rehab or Neurology
CCS, if Cerebral Palsy
Concern for Autism Spectrum Disorders
M-Chat if 18 mos+ and if child fails M-Chat, refer to PHN to follow up with RCEB referral.
Regional Center of the East Bay (RCEB) If under 3 y/o, child is Status 1, but should be started for *Status 2 (ongoing) eligibility by RCEB case manager so services are not stopped at age 3.
Clinic for ASD & ADHD Diagnostics (CAAD) We will generally refer to RCEB if before 3 y/o for RCEB to assess. However pending the case, CAAD may assess. At this time, if child has Medi-Cal and sole concern is Autism, RCEB should assess rather than CAAD.
Note: Resources to consider include: Care Parent Network & TBS (therapeutic behavioral school/special school). Care Parent Network (925.313.0999) referral to help the family navigate the education system i.e. IEP information/training. CARE offers support groups and trainings for families with Autism. RCEB Service Coordinator (case manager) should work with the family to make sure there is an appropriate education program in place.
*Please note: for kids over three years of age, contact RCEB intake 510-618-6122, if you have a concern of any of the following: Autism, Intellectual Disability (formerly known as Mental Retardation), Cerebral Palsy, Epilepsy, or 5th Category i.e. cognitive d/o NOS impacting ADL’s. These diagnoses generally qualify a child for Status 2 (ongoing lifetime) eligibility with RCEB.
Concern for ADHD
Pediatric Clinic: Vanderbilt Assessment Scales: Initially the parent/teacher should complete an assessment scale. Thereafter, both parent and teacher may complete a follow-up assessment scale. If you have the parent return in SASE to Maria Estrada and/or Krista Peterson at CAAD, please complete MR 191 - CAAD referral (via ccLink: please complete the ASD & ADHD Diagnostics Internal Referral). The Vanderbilt scales are free for us to use. We pay for the Conners’ Rating Scales.
Clinic for ASD & ADHD Diagnostics (CAAD - formerly known as Child Development Clinic or CDC) (Please complete ccLink ASD & ADHD Diagnositcs Internal Referral or if outside ccLink, FAX a detailed referral via MR 191-CAAD to fax# 925.370.5277). The new MR 191 CAAD form is located on gold star icon Medical Forms on CCHS computers. If you would like the CAAD to review a case without a full assessment, please specify a consult. If you would like to refer for a full ADHD evaluation, medication management or stabilization -if previously diagnosed with ADHD, please let CAAD staff know.)
Note, foster children require court document JV220/ JV220a (Authorization to treat with psychotropic med) to be completed prior to treating foster children with medications.
Behavioral Problems (often under Mental Health) Early Child Mental Health Programs for Children ages 0-6
Lynn Center, Pittsburg 925.439.9628
We Care, Concord 925.674.0777
Early Childhood Mental Health, Richmond 510.412.9200
CHILD CARE SOLUTIONS PROGRAMS 925.686.0207 - Most mental health programs can offer Wraparound services and/or Preschool Intervention to assist staff working with kids with behavioral challenges.
Once school age, the school can assess for counseling services via the school district and can implement a behavioral plan for education if needed. There are several school programs for severely emotionally disturbed.
Check development (i.e. Denver, ASQ, and ASQ-SE)
Mental Health Resources for over six y/o
Call MH ACCESS# 1.888.678.7277 for authorization for over 6 y/o.
If the child has CCHP (“H” financial codes, commercial CCHP) the family should call 925.313.6683
Family can also call 2-1-1 to request a list of current resources for sliding scale therapy. (2-1-1 also has information on local support groups and other helpful information.)
Concern for Psychiatric Disorders
Mental health referral: complete REFERRAL FOR MR395 (7-11) MENTAL HEALTH SERVICE CHILD/YOUTH located on gold star icon. Or click here
Dr. Andelman for phone consult to PCP
Learning Disabilities or Intellectual Disabilities
School District Referral: see http://www.cccoe.k12.ca.us/directory/ for current Public School phone directory. Parents have to request in writing for their child to have school evaluations done (i.e. speech and language, psycho-educational evaluation). Parents can request a meeting at anytime. If child is delayed/doing poorly in school, the parents should ask for a SST meeting (Student Success Team). The next step is to request in writing an evaluation for developing an IEP (Individual Education Program).
School psychologist should perform psycho-educational testing to identify current cognitive level of functioning if this is a concern.
Refer to RCEB for c/o ID, regardless of age as ID is a qualifying dx for over 3 y/o and the individual can receive services for life.
Care Parent Network (925.313.0999 for English and Spanish speaking families) can work with families to arrange a special folder to keep track of all educational evaluations, SST meetings, and IEP documents. Care Parent Network can assist family with booklets available in print or via website re: differences in IEP and 504 plans. They can help with health binders too.
East Bay Learning Disabilities Association: 510.433.7934 or www.eastbaylda.org
School Districts (Phone & fax numbers may have changed please see website for current information) http://www.cccoe.k12.ca.us/directory/
Antioch Unified School District 925.706.5343
Brentwood Unified School District 925.513.6315
Byron Union School District 925.634.6644
Canyon Elementary School Dist. 925.376.4671 John Swett Unified School District (JSUSD): (Rodeo, Crockett and parts of Hercules)
Special Ed Evals 3-5 years old- call 510.787.3040OR 5-22 years old – contact school of attendance
Knightsen School District 925.625.0073
Lafayette School District 925.299.3510
Martinez Unified School District: 925.313.0480 x 217
Moraga (administered by WC) 925.944.6850 x 123
Mt. Diablo Unified School District (MDUSD): 925.825.0144 (Bay Point, Concord, Pleasant Hill, & part of Walnut Creek)
Oakley Unified School District 925.625.7060
Orinda Union School District 925 254.4901 x 6216
Pittsburg Unified School District 925.473.4278 (doesn't include Bay Point)
San Ramon Valley Unified School Dis. 925.820.6815
Walnut Creek School District 925.944.6850 x 123 West Contra Costa Unified School District (WCCUSD) Birth to 5 - Cameron School 510.233.1955 -serving El Cerrito, Richmond, San Pablo, Pinole, El Sobrante and parts of Hercules):Ages 5 to 22 years old - contact school of attendance.
Pediatric Algorithms
Speech Delay Referrals if under 3 y/o (36 months):
Speech Delay Referrals if over 3 y/o:
Click here for directory
If the child is already known to have a hearing loss or is deaf hard of hearing (DHH), please consider the local school district for the Solely Low Incidence program, regardless of the age. In addition, for vision, hearing, or orthopedic impairments in children birth to three, please contact the local school district and/or CCC Office of Education www.cccoe.k12.ca.us
Gross Motor Delay Referrals
If under 3 y/o:
- RCEB
- Pediatric or CHO Neuro eval, if indicated
- CCS, if specific criteria are met
If over 3 y/o:Concern for Autism Spectrum Disorders
*Please note: for kids over three years of age, contact RCEB intake 510-618-6122, if you have a concern of any of the following: Autism, Intellectual Disability (formerly known as Mental Retardation), Cerebral Palsy, Epilepsy, or 5th Category i.e. cognitive d/o NOS impacting ADL’s. These diagnoses generally qualify a child for Status 2 (ongoing lifetime) eligibility with RCEB.
Concern for ADHD
Behavioral Problems (often under Mental Health)
Early Child Mental Health Programs for Children ages 0-6
Once school age, the school can assess for counseling services via the school district and can implement a behavioral plan for education if needed. There are several school programs for severely emotionally disturbed.
Check development (i.e. Denver, ASQ, and ASQ-SE)
Mental Health Resources for over six y/o
Concern for Psychiatric Disorders
Learning Disabilities or Intellectual Disabilities
School District Referral: see http://www.cccoe.k12.ca.us/directory/ for current Public School phone directory. Parents have to request in writing for their child to have school evaluations done (i.e. speech and language, psycho-educational evaluation). Parents can request a meeting at anytime. If child is delayed/doing poorly in school, the parents should ask for a SST meeting (Student Success Team). The next step is to request in writing an evaluation for developing an IEP (Individual Education Program).
School Districts
(Phone & fax numbers may have changed please see website for current information)
http://www.cccoe.k12.ca.us/directory/
Antioch Unified School District 925.706.5343
Brentwood Unified School District 925.513.6315
Byron Union School District 925.634.6644
Canyon Elementary School Dist. 925.376.4671
John Swett Unified School District (JSUSD): (Rodeo, Crockett and parts of Hercules)
Special Ed Evals 3-5 years old- call 510.787.3040 OR 5-22 years old – contact school of attendance
Knightsen School District 925.625.0073
Lafayette School District 925.299.3510
Martinez Unified School District: 925.313.0480 x 217
Moraga (administered by WC) 925.944.6850 x 123
Mt. Diablo Unified School District (MDUSD): 925.825.0144 (Bay Point, Concord, Pleasant Hill, & part of Walnut Creek)
Oakley Unified School District 925.625.7060
Orinda Union School District 925 254.4901 x 6216
Pittsburg Unified School District 925.473.4278 (doesn't include Bay Point)
San Ramon Valley Unified School Dis. 925.820.6815
Walnut Creek School District 925.944.6850 x 123
West Contra Costa Unified School District (WCCUSD) Birth to 5 - Cameron School 510.233.1955 -serving El Cerrito, Richmond, San Pablo, Pinole, El Sobrante and parts of Hercules):Ages 5 to 22 years old - contact school of attendance.